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a monoclonal antibody against respiratory syncytial virus, used as a passive immunizing agent against infection with the virus in susceptible infants and children; administered intramuscularly.



Pharmacologic class: Monoclonal antibody

Therapeutic class: Immunologic agent

Pregnancy risk category C


Neutralizes and suppresses activity of syncytial virus in respiratory tract, inhibiting respiratory syncytial virus (RSV) replication


Injection: 50 mg, 100-mg vial

Indications and dosages

To prevent serious lower respiratory disease caused by RSV in high-risk children

Children: 15 mg/kg I.M. q month throughout RSV season


• Hypersensitivity to drug or its components


Use cautiously in:

• thrombocytopenia, coagulation disorders, established RSV infection.


Keep epinephrine 1:1,000 available in case anaphylaxis occurs. (However, drug isn't known to cause anaphylaxis.)

• Dilute in sterile water for injection. Gently swirl for 30 seconds to avoid foaming.

• Keep reconstituted solution at room temperature for at least 20 minutes before administering. Give within 6 hours of reconstitution.

• Inject I.M. into anterolateral thigh. Avoid gluteal injection, which may damage sciatic nerve.

Adverse reactions

CNS: nervousness, pain

EENT: conjunctivitis, otitis media, rhinitis, pharyngitis, sinusitis

GI: vomiting, diarrhea, gastroenteritis, oral moniliasis

Hematologic: anemia

Respiratory: upper respiratory tract infection, cough, wheezing, dyspnea, bronchiolitis, bronchitis, pneumonia, croup, asthma, apnea

Skin: rash, fungal dermatitis, eczema

Other: hernia, pain, fever, injection site reaction, viral infection, flulike symptoms, failure to thrive


Drug-diagnostic tests. Alanine aminotransferase, aspartate aminotransferase: increased levels

Hemoglobin: decreased level Immunological-based RSV diagnostic tests: interference, possibly leading to false-negative test results

Patient monitoring

Watch closely for signs and symptoms of anaphylaxis immediately after dosing.

• Assess for signs and symptoms of infection, particularly EENT and respiratory infection.

• Monitor liver function tests and CBC.

• Assess patient's weight and hydration status.

Patient teaching

• Tell parent that monthly injections are necessary during RSV season (November through April).

• Inform parent that drug may cause GI symptoms and failure to thrive. Provide dietary consultation as needed.

Caution parent that EENT and respiratory infections may follow administration. Advise parent to contact pre-scriber immediately if child has fever or other signs or symptoms of infection.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.


/pal·i·viz·u·mab/ (pal″ĭ-viz´u-mab) a monoclonal antibody against respiratory syncytial virus (RSV); used as a passive immunizing agent in susceptible infants and children.


a monoclonal antibody.
indications It is used to prevent serious lower respiratory tract disease caused by respiratory syncytial virus in pediatric patients.
contraindications Use is prohibited in adults, in patients with cyanotic congenital heart disease, and in patients with known hypersensitivity to this drug.
adverse effects Adverse effects include nausea, vomiting, diarrhea, increased AST, upper respiratory infection, otitis media, rhinitis, pharyngitis, rash, and injection site reaction.


Synagis® Immunology A humanized monoclonal antibody used as prophylaxis against RSV infection Adverse effects Fever pneumonia, and injection site reactions. See Respiratory syncytical virus.
References in periodicals archive ?
NREVSS surveillance data reflect recent circulation patterns of RSV and might inform policy decisions regarding administration of palivizumab for immunoprophylaxis.
Nine medicines incorporated received more than 250 responses (just one had more than 500): fingolimod for the 3rd line of treatment of multiple sclerosis (530 responses); cinacalcet and paricalcitol for therapy related to secondary hyperparathyroidism on chronic renal diseases requiring dialysis; antiviral dolutegravir sodium for HIV-related infections; palivizumab for the prevention of infections related to the respiratory syncytial virus, and sofosbuvir, daclatasvir and simeprevir indicated for chronic hepatitis C.
One of the early successes was with the primary care RN team improving palivizumab compliance rates, not only at the start of the project, but demonstrating sustained results over time.
Another parent recognized that her child received palivizumab (Synagis[R]) injections (a monthly injection to protect high-risk infants and young children against respiratory syncytial virus) during her scheduled pulmonary appointments and suggested a similar approach for other clinics: "Sometimes they would combine my appointments so I wouldn't have to go twice.
However, the widespread use of palivizumab has been impeded by the logistics to provide monthly intramuscular injections for 4-5 months of the year while the RSV circulates in temperate climates, and by its cost, which makes it unaffordable and not cost-effective in most countries.
For infants at very high risk of serious RSV infection, passive antibody protection is already administered in the form of the pharmacobiologic medication palivizumab.
The monoclonal antibody palivizumab is available to prevent severe RSV disease; however, due to its extremely high cost, it is only used in very limited numbers of infants (e.
Monoclonal antibodies: Palivizumab is an engineered antibody against RSV.
Although immunization strategies such as Palivizumab, which aims to prevent serious and often life-threatening lung infections caused by respiratory syncytial virus (RSV), target premature newborns and at-risk newborns with significant lung disease, the growing premature newborn remains at an increased risk for RSV infection, particularly in the lower respiratory tract of the lung (American Academy of Pediatrics 2009; Hall et al.
The American Academy of Pediatrics (AAP) has developed guidelines for palivizumab administration using data from previous RSV seasons to suggest a period for administration.
The guidelines advise that palivizumab (Synagis) should not be given to otherwise healthy infants with a gestational age of 29 weeks or greater.
Cost utility of prophylaxis with palivizumab versus no prophylaxis in children with risk of infection of syncitial respiratory virus in Colombia